This paper analyzed the clinical data, diagnosis and treatment of 4 asymptomatic patients with ureteral calculi without hydrops in our hospital from October 2018 to January 2019, and comprehensively discussed the previous literature. The 4 patients in this group had no obvious clinical symptoms, no positive stones were found in the B-ultrasound of the urinary system, and no hydroureter and hydroureter of the affected side was found. Urinary CT scan confirmed ureteral stones. They were all located in the lower ureter, and the stones obstructed the lumen. The stones were round and smooth, and there was no obvious hyperplasia and edema in the surrounding mucosa. The lithotripsy was completed in the first-stage operation, and the DJ catheter was left behind for one month after the operation. Based on the clinical diagnosis and treatment process of the 4 cases of asymptomatic calculi in this group and the analysis of previous studies, these patients were mostly detected by imaging examinations or other systematic imaging examinations during the regular review of urinary calculi. Ureteral stones with obstruction did not necessarily have stone-related symptoms. The onset of renal colic involved an increase in intraluminal pressure, related stimulation of nerve endings, smooth muscle spasms caused by stretching of the ureteral wall, and systemic changes in cytokines and related hormones. Cascade reactions, etc., were associated with the movement of stones down. Ureteral stones without hydrops were mostly located in the lower ureter, which had a certain buffering effect on obstructive pressure. Asymptomatic ureteral calculi could also induce irreversible damage to renal function, and the proportion of damage increased with the diameter of the stone. Patients with a history of urinary calculi, especially those with asymptomatic stones for the first time, should be paid attention to during clinical follow-up. At present, there are few research reports on asymptomatic and non-accumulating ureteral calculi. We analyze the clinical diagnosis and treatment process and characteristics of this group of patients combined with previous literature to provide a reference for the diagnosis and treatment of such patients.
Humans ; Ureteral Calculi/therapy* ; Urinary Calculi/therapy* ; Ureter ; Lithotripsy/methods* ; Edema/therapy* ; Kidney Calculi/therapy*

Combined Modality Therapy ; Humans ; Male ; Phytotherapy ; Prostatic Diseases ; therapy ; Urinary Calculi ; therapy ; Urologic Neoplasms ; therapy

From April to October, 1988, 34 patients with ureteral calculi more than O.5 cm or smaller but impacted ureteral stone underwent pulsed dye laser lithotripsy under ureteroscopy. The results were as follows : 1. The locations of stone were upper ureter in 9(26.5%), mid ureter in 8(23.5%), lower ureter in 11(32.4%), and UVJ in 6(17.6%). 2. The success rates according to location were 66.7% in upper ureter, 87.5% in mid ureter, 91% in lower ureter, and 100% in UVJ and the average success rate was 85.3%. 3. The success rates according to stone size were 83% in 0.3-0.5 cm, 90% in 0.5-1.0 cm, and 75% in 1.0-2.3 cm. 4. The average procedure time was about 85 minutes, with a range of 30 to 120 minutes and the average hospitalization after laser therapy was about 3 days, with a range of 1 to 6 days. 5. There were 5 cases (14.8%) of failure due to upward migration of stone in 3 cases, ureteral injury in 1 case and ureteral stricture in 1 case. 6. Complications occurred in 10 patients (29.5 %), almost by ureteroscopy but laser induced complication was not found. Therefore, we confirm that laser lithotripsy is a safe and effective method for treatment of ureteral stone.
Constriction, Pathologic ; Hospitalization ; Humans ; Laser Therapy ; Lasers, Dye* ; Lithotripsy ; Lithotripsy, Laser ; Ureter* ; Ureteral Calculi* ; Ureteroscopy* ; Urinary Calculi

Management of urologic patients is being gradually but dramatically altered with new advances in technical innovation and refinements of interventional uroradiology. The broadening of indications for percutaneous nephrostomy became possible only after it was learned that it is a safe and effective means of establishing access to the renal collecting system. Percutaneous stone extraction (Nephrolithotomy) and Endopyelotomy are now well established procedures. These techniques have clear advantages over the surgical treatment for the same conditions and will increase the quality of patient care and reduce health care cost.
Human ; Kidney Calculi/therapy ; Kidney Diseases/diagnosis ; Lithotripsy ; *Nephrostomy, Percutaneous/contraindications ; Urinary Tract Infections/diagnosis/therapy

Food Contamination ; Humans ; Infant ; Triazines ; toxicity ; Urinary Calculi ; diagnosis ; etiology ; therapy

OBJECTIVETo determine the efficacy and incidence of complications of extracorporeal shock-wave lithotripsy (ESWL) compared with pneumatic ureteroscopic lithotripsy (URSL) in the treatment of lower uretheral calculi.

METHODSFrom August 1997 to June 1999, 210 patients with lower ureteric calculi were treated with ESWL and the other 180 with URSL. The stones were fragmented with pneumatic lithotripter. The outcome was assessed by evacuation, retreatment and complication rates.

RESULTSESWL for lower ureteric calculi resulted in a stone evacuation rate of 78.1%, compared with 93.3% for URSL (P < 0.05). ESWL had a retreatment rate of 11.9% and a perforation rate of 0, while URSL caused perforation of ureters in 3.3% of patients and a refreatment of 2.2%.

CONCLUSIONFor the management of lower ureteric calculi, ESWL provides a non-invasive, simple and safe option, and URSL has a higher stone evacuation rate but causes ureter perforation more frequently than ESWL does. Both ESWL and URSL have their respective advantages. It is recommended, however, that URSL be extensively developed for better treatment efficacy, given that the operator has an adequate technical background.

Adolescent ; Adult ; Aged ; Female ; Humans ; Lithotripsy ; adverse effects ; methods ; Male ; Middle Aged ; Ureteroscopy ; Urethral Diseases ; therapy ; Urinary Calculi ; therapy

PURPOSE: The lithogenic risk factors were compared between the first time stone patients and recurrent stone patients according to age and gender. MATERIALS AND METHODS: We performed stone metabolic studies on first time stone formers (67 men and 42 women) and the recurrent stone formers (40 men and 20 women). We analyzed the groups' excretion differences for the lithogenic and inhibitory constituents such as calcium, uric acid, oxalate, sodium and citrate; we measured volume from the 24-hour urine samples and calcium, uric acid, sodium, potassium, chloride and phosphate from the serum samples. Hypercalciuria, hyperoxaluria, hypocitraturia and a low 24-hour urine volume (<1,500ml) were compared between the two groups according to age and gender. RESULTS: Hypocitraturia was the most common metabolic abnormality in all the groups. The incidence of hypocitraturia was higher in the recurrent stone formers (50.0%) than in the first time stone formers (48.6%), but this was not statistically significant. A low urine volume was shown to have more significant association (p<0.05) for recurrent stone formers (33.3%) compared to the first time stone formers (18.3%). CONCLUSIONS: Hypocitraturia was the most common lithogenic risk factor for stone patients. In the recurrent stone formers, a low urine volume is the risk factor that differentiates them from the first time stone formers.
Calcium ; Citric Acid ; Fluid Therapy ; Humans ; Hypercalciuria ; Hyperoxaluria ; Incidence ; Male ; Oxalic Acid ; Potassium ; Risk Factors* ; Sodium ; Uric Acid ; Urinary Calculi

OBJECTIVETo evaluate the strategy for management of urosepsis after extracorporeal shock wave lithotripsy (ESWL).

METHODSThe clinical data were analyzed in 4 cases of urosepsis caused by ESWL during the period from January, 2008 to October 2011.

RESULTSTwo of the patients had kidney stones and two had ureteral stones. Analysis of urine bacterial culture revealed the presence of E. coli in 2 cases, Klebsiella pneumoniae in 1 case and Pseudomonas putida combined E. coli in 1 case. All the 4 patients were monitored for ECG, blood pressure and oxygen saturation, and received fluid replacement and anti-inflammatory therapy. The vital signs of the patients became stable after 5-11 days (mean 6.75 days). Three patients underwent ureteroscopic lithotripsy, and 1 patient had emergency ureteral stent indwelling. All the 4 patients were cured and discharged.

CONCLUSIONESWL is more likely to cause urosepsis in patients with ureteral stones and urinary infection, for which early nonsurgical interventions should be administered immediately after the diagnosis is established.

Adult ; Female ; Humans ; Lithotripsy ; adverse effects ; Male ; Middle Aged ; Retrospective Studies ; Sepsis ; etiology ; therapy ; Ureteral Calculi ; therapy ; Urinary Tract Infections ; etiology ; therapy

To analyze types of urinary calculi and patients' clinical characteristics, and to explore the strategies for prevention and treatment of urinary calculi.
 Methods: A total of 1 849 patients with urinary calculi were treated in the Department of Urology, the Third Xiangya Hospital of Central South University. The components were analyzed by infrared spectroscopy. The relationship between stone composition and clinical parameters was analyzed according to the clinical characteristics of the patients.
 Results: The proportion of calcium oxalate stone or uric acid stone in male (84.1% or 7.7%) was higher than that in female (78.4% or 4.2%). The older patients were more likely to be diagnosed as uric acid stone. The proportions of uric acid stone in patients <18 years old, 18-<41 years old, 41-<66 years old, and ≥66 years old were 0.0%, 1.6%, 6.6%, and 12.4%, respectively. There was no significant difference in the proportion of stones in patients with different BMI. There were no significant difference in the stone composition between the patients with or without urinary tract infection, hypertension or diabetes. The proportion of uric acid stones in patients with acidic urine was higher than the other types. The proportion of uric acid stones in patients with elevated creatinine (12.1%) was higher than that in the patients with normal creatinine (4.5%).
 Conclusion: Elderly patients, or patients with high uric acid and renal insufficiency are more prone to uric acid stones. Regulation of urinary pH may be an important strategy for preventing and treating urinary calculi in Hunan Province.
Adolescent ; Adult ; Age Factors ; Aged ; Body Mass Index ; Calcium Oxalate ; analysis ; Creatinine ; urine ; Female ; Humans ; Hydrogen-Ion Concentration ; Kidney Calculi ; chemistry ; therapy ; Male ; Middle Aged ; Sex Factors ; Spectrophotometry, Infrared ; Uric Acid ; analysis ; Urinary Calculi ; chemistry ; therapy ; urine

OBJECTIVETo summarize clinical characteristics, diagnosis and treatment of infants with urinary calculus and acute renal failure developed after being fed with melamine tainted formula milk.

METHODSData of infant patients with urinary calculus and acute renal failure due to melamine tainted formula milk admitted to the Beijing Children's Hospital affiliated to the Capital Medical University and the Xuzhou Children's Hospital in 2008 were used to analyze the epidemiological characteristics, clinical manifestations, image features as well as effects of 4 types of therapies.

RESULTSAll the 34 infants with urinary calculus were complicated with acute renal failure, their blood urea nitrogen (BUN) was (24.1 +/- 8.2) mmol/L and creatinine (Cr) was (384.2 +/- 201.2) micromol/L. The chemical analysis on the urinary calculus sampled from 14 of the infants showed that the calculus contained melamine and acidum uricum. The time needed for the four types of therapies for returning Cr to normal was (3.5 +/- 1.9) d for cystoscopy group, (2.7 +/- 1.1) d for lithotomy group, (3.8 +/- 2.3) d for dialysis group, and (2.7 +/- 1.6) d for medical treatment group, which had no statistically significant difference (P = 0.508). Renal failure of all the 34 infants was relieved within 1 to 7 days, averaging (3.0 +/- 1.8) d.

CONCLUSIONMelamine tainted formula milk may cause urinary calculus and obstructive acute renal failure. It is suggested that firstly the patients with urinary calculus complicated with acute renal failure should be treated with dialysis or medication to correct electrolyte disturbances, in particular hyperkalemia, and then relieve the obstruction with available medical and surgical methods as soon as possible. It is observed that the short term prognosis is satisfactory.

Acute Kidney Injury ; diagnosis ; epidemiology ; therapy ; Child, Preschool ; China ; epidemiology ; Female ; Humans ; Infant ; Infant Food ; Male ; Triazines ; toxicity ; Urinary Calculi ; diagnosis ; epidemiology ; therapy